Belfast Telegraph

Friday 22 August 2014

'It's like a bomb inside your brain'

Richard Gill's fiancee died of carbon monoxide poisoning at their Moroccan riad. Miraculously, he lived - but his struggle had only just begun

"There's no easy way to tell you this, Richard, but I'm afraid Carine didn't make it. I'm so sorry." But there was no need for my mother to say it. I had already realised as soon as I regained consciousness in a private clinic in Casablanca, Morocco. Looking to my right, the only other bed in the room was empty. My lovely fiancee, Carine, was dead.



I had been taken to the clinic from our riad renovation project in Azemmour, 85km south of Casablanca, and spent two days in a coma. The cause: a 2ft-diameter charcoal grill.



Our 110sq m renovation project felt huge, with three bedrooms, a kitchen, a giant salon and room for two bathrooms, with a great roof terrace overlooking the Atlantic and miles of beautiful countryside. Dar Ben Abderrahaman XI was an ancient property in need of some serious love and attention, but after living with Carine's family of Congolese immigrants in a south London flat for months, we were absolutely ready for it. We left riding pillion on my 500cc Piaggio Beverley, making it from London to Azemmour in six days.



Azemmour's medina is breathtakingly enchanting. Most locals wear the jilaba, the traditional long-hooded robe reaching down to the feet, and baboosh slippers with no back or heel. Built where Morocco's biggest river, the Oum R'bia, meets 35km of pristine Atlantic coastline, the medina is a bizarre maze of narrow cobbled streets and 16th-century ruins.



Walking through its streets leaves one with a sense of biblical times. Kids and cats are everywhere on the sloping cobbles; the older women exchange gossip over the water fountain. There is a mains water supply, but most can't afford it. Azemmour has 30,000 occupants and virtually no work. The only children's toys are marbles and footballs - no coat-tugging brats nagging for a PS3. But this lifestyle is a real eye-opener, built entirely around the family and the core Islamic tenet of sharing.



The next three months were the funniest, most enjoyable of our lives. Carine was initially reticent about moving to Morocco, largely due to its reputation on women's rights, and the thought of having to cover her whole body in a hot climate. But her strength in overcoming these was astounding. She was proud to be the only black person in Azemmour, and was adamant about wearing exactly what she wanted (though I did notice the odd pair of trousers replacing a miniskirt).



After another hard day's work on 13 December 2006, we spent a fun evening cooking some kebabs for the neighbours' kids. After dinner at around 10.30pm, I took the grill up to our terrace bedroom to keep us warm, parked it at the foot of our bed, and, spying just one or two last embers, left the door slightly ajar to err on the side of caution. Tragically, at some point during the night, Carine must have felt the cold and tapped the door shut with her foot, which led to 10 hours of carbon monoxide poisoning, putting me in a deep coma and putting my very special young soulmate to sleep.



At 8.45am, our neighbour Abdel Kbir was in prayer and had what he describes as a "shuddering sensation". He knew something was wrong. Looking out of his window, he saw our building crew standing outside our riad door instead of inside, working. Rushing downstairs, he shouted at our head builder, Omar, to smash through the heavy front door with a sledgehammer, and they all ran up the 42 concrete steps to our roof terrace room, where through the closed glass door they could see us both lying unconscious. Well, I was unconscious. Carine had been dead for three hours or so. She was still cuddling Ben, our 20-day-old Staffie.



I was dragged down the 42 steps on my back, barely breathing. A local off-duty fireman arrived and gave me mouth-to-mouth on our doorstep. Someone else summoned one of the two ambulances in the El Jadida region. Ten men then carried me on a stretcher of wooden building planks to the medina gates, where a huge crowd had gathered to see the strange foreigner thrown into the ambulance. I was taken 13km to El Jadida hospital, had a major seizure en route and fell deeper into coma. This hospital had none of the necessary ventilation equipment to keep me alive, so the British Embassy arranged to have me taken by private ambulance 95km north to the clinic in Casablanca.



It was 41 hours before I opened my eyes as wide as they could go, sprang bolt upright and tugged out various leads, triggering a loud buzzer. Gently - Moroccans are by far the kindest, most gentle people I have ever met - the clinician came to my bedside, reconnected everything and told me where I was.



As is often the case with coma, the patient's initial recovery or "awakening" is a result of aural stimulation. For me, it was the sound of a clinician's voice, quietly praying to Allah on a mat across the room. Bizarrely, my initial state of mind was euphoric, as if nothing in the world could or would ever matter, as though I had never experienced stress or pressure of any kind. This must be the Islamic promise of paradise. As if to confirm it, the majestic grand central mosque of Casablanca began its haunting lunchtime call to prayer.



To my parents, who were with me in the clinic, I appeared to be making a miraculous recovery - walking around, chatting, my memory evidently intact. The only thing my mind had blocked out was the accident. I later learned that this was post-traumatic amnesia (PTA). I was keen to see Carine, perhaps not quite yet believing that she had gone. So I insisted against the clinic's advice that I should be discharged. My parents took me back down to Azemmour, where I made a police report, then to El Jadida morgue where Carine's body lay on a trolley. We had from time to time discussed death, and Carine had always said she just wanted me to kiss her on both eyes and tell her that everything would be OK. It was an incredibly hard thing for me to do on my own, but I was happy to fulfil her wish and to see no painful expression - just peace.



My parents were now eager to take me away from Azemmour, so we flew to Faro for some recovery time at their villa. Again, I felt fine. Then it started.



I noticed myself that things were going wrong when I wet the bed in the villa. From this point on, my demise was even more spectacular than my apparent recovery. Before long, I had no idea where on earth I was or whom I was with. This vicious freefall from relief to despair is typical of many forms of brain injury, especially following coma and PTA.



The best analogy I have found is to consider the brain as a highly complex traffic system. When the full effects of CO smash the central nervous system, it is the scale of disruption one might expect from a massive bomb exploding at a busy intersection. Imagine the devastation of a bomb in your brain. Once our brain cells have been destroyed, they are gone for good. But our brains are phenomenal structures. The neurons, feeling unemployed, zip around looking to make fresh connections with other under-utilised brain cells, until some sort of normality is hopefully restored to the nervous system, allowing the victim to move, speak, remember faces and events, and organise his or her life.



Lasting recovery has to be facilitated by a process of rehabilitation, which can take months or years. My first 14 weeks back in the UK were spent in Huddersfield Royal Infirmary, where for six weeks, despite the assistance of 20 great nurses, I was doubly incontinent and could not walk, talk, eat (my sister Julie had to spoon-feed me) or even cry. My parents flew over to visit me but I didn't know who they were.



From Huddersfield I was referred to a leading brain rehabiliation centre. After six months, I am now almost well enough for discharge. Apparently, I am the only person known to have survived 10 hours of exposure to carbon monoxide. The head neuropsychologist, Dr John Freeland, said: "You're one in a billion. Next time you're heading for Vegas, take me!"



Only now, after six months of rehab, am I able to make any sort of plan for the future. Islam has a strong role in it, but this country does not. I have started a book, One in a Billion, a cathartic experience, and I'm working to raise global awareness about the dangers of carbon monoxide produced by solid fuels.

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